What We Did While Baseball Season Went Awry

Most of the Nolan family* went to the last Mariners game of the season this past Sunday afternoon. Despite a bit of a rally in the eighth and ninth innings, the Ms basically went quietly into the night. The Red Sox won their last game, but really that's not much to celebrate as the Yankees head off to the postseason and the Good Guys clean out their lockers. Ah well.

Anyways, while I was sitting in my (really nice, we splurged) seat, mourning the end of another baseball season, I got to thinking about all the stuff we've been working on over the summer months, and how so much of it is popping out of the oven this week, just in time for the Health 2.0 Conference in San Francisco. And while I'm all about taking our fair share of the credit --- I realized that, against all odds and precedent, the folks at HHS and ONC have really succeeded in accelerating some key initiatives around personal and data-driven health.

At least in the world I live in, this is really big news --- the federal government, in the persona of new and old faces like Arien Malec, Todd Park, Greg Downing, Lorraine Doo and Peter Levin (not to mention a ton of decidedly non-governmental participants like Carol Diamond and Josh Lemieux at the Markle Foundation), have somehow figured out how to get things done that are going to make a real difference.

Even better, Microsoft is simply in a fantastic position to play a key role in accelerating this work. I often talk about how my boss Peter Neupert convinced me that MS was the right place to make a difference in health. No matter how you look at things, the reality is that nobody else has the breadth to take a full ecosystem view of the problem --- from consumers and patients with HealthVault, right through to the delivery system and providers with Amalga and HealthVault Community Connect. And that end-to-end bag of tricks is what it's going to take to help deliver the fundamental changes that our system needs.

With so much awesome stuff going on, the Health 2.0 conference this year is shaping up to be a whole bunch of fun. I'll be talking about our CHDI and Blue Button work, and David Cerino and some other folks on the team will be showing off HealthVault Community Connect and the great momentum we're seeing in the HealthVault ecosystem.

Just a few of the federal-led initiatives that we've had the opportunity to participate in recently:

Real data is incredibly powerful, especially in a domain like health where there are so many variables and it can be tough to correlate what really matters and what doesn't. Both patients and providers are being asked to be more efficient and smarter about the choices they make. But without good data --- good luck with that.

Well, HHS realized that (surprise) as supporters of research and the biggest payer in the country, they were sitting on a ton of incredibly rich data --- most of it easy to release into the public domain. So they did, and asked third parties to see what they could make happen with it. The first wave of results was pretty cool, and this week we're seeing the results of the next round of innovation to come out of their Health 2.0 Challenge.

For our part, we've created some great consumer tools like Bing Health Maps --- and perhaps even more exciting, we've integrated the data into our enterprise products as well. Our Amalga customers can load CHDI data into their Amalga data asset with little more than a click, where it can be connected with clinical data to benchmark hospital performance, drive research around community health, identify risks in real time, or educate patients on potential risks for conditions like asthma or diabetes. Totally, totally sweet.

Another simple idea --- since CMS and the VA already share health information with citizens through their web portals, why not just let them download it in a form that they can share with providers and innovative personal health services like HealthVault, Keas and Google Health?

Rather than let themselves get talked to death on this, they just did it --- and the Markle and Robert Wood Johnson Foundations issued another Health 2.0 Challenge to see what great services could be created on top of the data. We've just released the capability to upload Blue Button information to HealthVault, where it can be used to drive experiences in family health management, chronic condition management, emergency preparedness and more. An incredible win for vets and Medicare beneficiaries, and all at almost zero cost to the government.

Now --- just to show that I'm not just a complete fanboy --- as I've told the agencies many times now, the format of the Blue Button files is frankly just crazy bad from an integration perspective. I wrote our parsers, and they ain't pretty. In order to get really broad adoption, we need a version two in pretty short order, ideally moving to something like a CCD or CCR. But given the choice between these files and no files --- no brainer, and we're thrilled. Do it, try it, fix it.

A ubiquitous National Health Information Network is still a long way off. The technology underlying it is super-complicated, policies around privacy and data use restrictions are still unclear, and honestly nobody is really sure where the sustainable economics are anyways. But it's a political grenade, and not something that folks have wanted to challenge.

Until now, when the government listened to Wes Rishel and David McCallie when they suggested that maybe we needed to also (not instead) think about a simpler kind of interoperability that didn't require such huge leaps across so many domains. The result was NHIN Direct, a project that hopes to enable simple and secure electronic "push" messaging for providers and patients, even those that haven't yet implemented an EMR.

Think about this --- by the end of the year, we will be running pilots sharing real health information freely amongst providers and patients, with clear policy guidance and a clear line of sight to broad regional and even national adoption. WOW.

We really believe in this idea --- and have with many other key industry players put our resources behind it. My colleague Umesh has written a huge chunk of one of the two open source reference implementations, and we will be issuing NHIN Direct addresses to every HealthVault user when the first pilots go live in a couple of months.

Government isn't the answer to our challenges around Healthcare. But they have to be a key part of that answer, and it's just incredibly gratifying to see HHS and ONC taking on that responsibility with the kind of energy that success requires. If we can just keep up the momentum and make sure we don't get derailed by old thinking --- by the time pitchers and catchers report for spring training, we should have some serious proof points under our belt.